Fill out the application form below to apply for a Teach Rural Placement Name Email Address Phone Address Postcode Gender Gender Male Female Other Transport Transport I have my own licence/car I rely on public transport University Year of Study Course Name Placement Dates Placement Duration Year Level Year Level Primary Secondary Year Level(s) Preferred Methods Do you have any other students whom you would like to be with on placement? Please list their name(s). What are your interests? (Please include sporting, social, hobbies etc.) Why are you interested in teaching in a rural area? Please list any apprehensions or worries you have about teaching in a rural setting. (These comments will assist CEP to support PSTs in their placements and future employment.) Do you have any questions/queries about the initiative? A member of the CEP team will follow up on your questions and provide a response prior to you beginning your placement. 12 + 2 = Submit
